Sjögren's International Collaborative Clinical Alliance (SICCA) ocular staining score form

Ocular surface staining is assessed using fluorescein dye for the cornea and lissamine green dye for the conjunctiva. A sequential examination is required. First, fluorescein is instilled in each eye and corneal staining is assessed in a period of less than four minutes using a slit lamp outfitted with a cobalt blue filter. Second, a drop of 1 percent lissamine green dye is instilled in each unanesthetized eye. The number of discrete "dots" of staining in the cornea and in the nasal and temporal portions of the conjunctiva is counted for each eye and graded according to the schema shown here. A summation of the fluorescein score for the cornea and the lissamine green scores for the nasal and temporal bulbar conjunctiva yields the total ocular staining score for each eye. The maximum possible score for each eye is 12. Based on an analysis of the Sjögren's International Collaborative Clinical Alliance (SICCA) registry, an ocular surface score of 3 or more in either eye was considered to be abnormal and supportive of the ocular component of Sjögren's syndrome.